Provider Demographics
NPI:1962839019
Name:NEIGHBORHOOD DRUGSTORE INC.
Entity Type:Organization
Organization Name:NEIGHBORHOOD DRUGSTORE INC.
Other - Org Name:VNS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGORYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-553-3859
Mailing Address - Street 1:9305 63RD DR
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2924
Mailing Address - Country:US
Mailing Address - Phone:718-997-6900
Mailing Address - Fax:718-997-6901
Practice Address - Street 1:9305 63RD DR
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2924
Practice Address - Country:US
Practice Address - Phone:718-997-6900
Practice Address - Fax:718-997-6901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7026150001Medicare NSC